The Academic and Behavioral Impacts of an Autism Health Insurance Mandate: Evidence from Massachusetts

Stephanie Coffey ()
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Stephanie Coffey: Department of Economics Saint Anselm College Manchester, NH 03102

Education Finance and Policy, 2025, vol. 20, issue 1, 110-136

Abstract: Today, all 50 states have enacted mandates requiring some level of insurance coverage for the treatment of autism spectrum disorders (ASD). In this paper, I examine the impact of Massachusetts’ mandate, ARICA (An Act Relative to Insurance Coverage for Autism) on the academic and behavioral outcomes of students with ASD in the state. Using administrative data on Massachusetts public school students, I use a triple difference strategy to estimate impacts on special education setting, attendance, suspensions, and achievement. I find that ARICA increased inclusion for students with ASD; they were 4 percentage points more likely to be fully included after the reform. Further, days suspended decreased by about 26 percent, and the likelihood of receiving a suspension decreased by about 2 percentage points. I find that improvements in student outcomes were larger for students in grades 6–8 (versus elementary students). While I find no statistically significant improvement in test scores for students with ASD overall, math (English language arts) achievement increased by 0.09 (0.13) standard deviation for students in middle grades.

Date: 2025
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